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Mooney down over New Hall Pass • Los Angeles


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4 minutes ago, alextstone said:

I hope this comment is not out of line somehow...Was the aircraft equipped with an Aspen 1000 Pro Max? Did  it shut down to recycle (known issue with some units) during the approach?  Did the AHRS fail?

That would be awful if true and if it contributed to the suspected loss of control.  It’s way premature to speculate on instrument failure let alone a specific OEM.  For what it’s worth, one thing to consider if the plane has a certified EFD1000 install is that there would be a required backup ADI - so if the unit reset he would have immediately know (EFIS failures are pretty obvious vs vacuum gyro failures) and he could have shifted his scan to the backup.  Autopilot would have also disconnected so any Aspen issues would not translate to bad autopilot commands. Whatever happened - it seems like things went bad pretty quickly and overwhelmed the pilot’s ability to keep the aircraft under control.  Prayers for the families of those affected by this tragic accident.  Everyone stay safe out there and stay current in all training and currency requirements.
 

 

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10 minutes ago, alextstone said:

I hope this comment is not out of line somehow...Was the aircraft equipped with an Aspen 1000 Pro Max? Did  it shut down to recycle (known issue with some units) during the approach?  Did the AHRS fail?

It seemed to me like he was dealing with a failure of some kind.   I wonder whether if he had just spoken up about whatever was going on he'd have had more space and less pressure so that he could deal with the issue more easily.

Very sad situation from any angle.   

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1 hour ago, alextstone said:

I hope this comment is not out of line somehow...Was the aircraft equipped with an Aspen 1000 Pro Max? Did  it shut down to recycle (known issue with some units) during the approach?  Did the AHRS fail?

Or maybe it was Garmin, or a KI 258? 

I listened to the recording. The pilot was evidently having trouble navigating, first low and left of the localizer and then right of the localizer. I have no idea why and will not speculate, but the pilot never mentioned an equipment problem and indicated that he was correcting back on course when queried by the controller. After the first deviation, a different (supervisor?) controller took over communications and instructed the pilot to fly heading 160 and climb to 5000'. The pilot acknowledged the altitude, but not the heading which is why the controller repeated the instruction several times asking for confirmation that the pilot would fly 160. The pilot never did  acknowledge the heading and may not have initiated the climb because the controller then issued a simplified instruction to maintain altitude and fly south and subsequently he instructed the pilot to just fly straight and level. Somewhere around that time it appears that control was lost.

It's very sad and unfortunate and we will never know for sure exactly what happened in the cockpit. 

For me, the takeaway is to never try to salvage an approach. If everything isn't right, go missed early and get some altitude between you and the ground.

Skip

 

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1 hour ago, chriscalandro said:

That transcription is incomplete. The controller continues to repeat “fly straight and level”. 
 

when someone is clearly having an issue repeating the same useless comment is not useful or helpful in any way. 

It's really hard to know what the precise interplay was here between pilot disorientation and possible instrument failure(s). It seems like the controllers recognized the seriousness, and I'm not sure what more they could have done. Leveling the wings and arresting the descent seems like the #1 priority when this deep in trouble, and that's what they kept asking him to do.

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1 hour ago, ArtVandelay said:

I don’t know the pilot, but base on his poor read backs and confusion, Im wondering if this is another CO issue, he might have been on O2 at cruise level.

The plane had a KFC 200 autopilot?

I actually thought the same thing myself.  

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1 hour ago, chriscalandro said:

That transcription is incomplete. The controller continues to repeat “fly straight and level”. 
 

when someone is clearly having an issue repeating the same useless comment is not useful or helpful in any way. 

Unless he didn’t hear or understand it the first time then it’s pretty helpful!

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1 hour ago, alextstone said:

I hope this comment is not out of line somehow...Was the aircraft equipped with an Aspen 1000 Pro Max? Did  it shut down to recycle (known issue with some units) during the approach?  Did the AHRS fail?

A frozen or clogged pitot tube would not be fun on the ILS in IMC if the that was the case. 

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It's really hard to know what the precise interplay was here between pilot disorientation and possible instrument failure(s). It seems like the controllers recognized the seriousness, and I'm not sure what more they could have done. Leveling the wings and arresting the descent seems like the #1 priority when this deep in trouble, and that's what they kept asking him to do.

 

I hate speculating and won’t here. But I do take exception to someone inferring that an Aspen or any other manufacturer product was involved. Way too early for that.

 

I will say this about single pilot IFR in IMC. It’s the real deal. I have flown a ton of safety pilot flights and I can’t tell you the number of times I have seen pilots get significantly off course or off altitude on an approach with EVERYTHING working in the plane.

 

And for some pilots it doesn’t take much of a distraction or a lack of attention for things to fall apart quickly. It has happened to all of us at one time or another. We’ve been the lucky ones to catch it before it evolves into something bad.

 

Hopefully the NTSB will determine the cause and we learn from it.

 

 

Sent from my iPhone using Tapatalk Pro

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I couldn't agree more with @Marauder assessment above. The pilots multiple attempts at read backs from the beginning indicate he was stressed and over worked. Although one can't rule out an equipment problem, most would say so on a non-busy frequency when being told to correct course or heading. The sad truth is tackling an IMC approach in challenging conditions, including turbulence, is easily beyond the capability of pilot's that aren't proficient - without any equipment failures. Instrument flying skills are the fastest to perish. 

Sometimes the preliminary will tell us if an equipment failure is even a consideration or not but otherwise its going to be over a year before the final report is out. Not that we'll know for along time about what happened here, but my take away in these accidents is that one can never be too proficient flying in weather.

Two people lost - So very sad!

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On 3/14/2020 at 7:13 AM, chriscalandro said:

That controller certainly was not any help whatsoever. 

I do not agree.  VNY / BUR is a very busy airspace.  Moreover, VNY miss approach intercepts BUR RWY8 localizer.

The following screenshot is within the time controller repeatedly issuing the miss approach instructions.  You can see 777WP flying toward a C750 just took off from BUR.  I think that was the reason why when the pilot did not readback and the controller had to repeat.  But once the controller realized 777WP was about to be out of control, he immediately went into helping mode to help the pilot.  But it was too late.

image.thumb.png.4dd3b0e3dadf4e29bd83bcca6b491858.png

Added:  Here is another screenshot on 14:47 moment before he crashed.  You can see BUR was extremely busy.  A Global Express GLEX just departed while SWA about to land. A Skywest was lineup and wait for taking off at BUR. (The yellow plane on the left side was 777WP).

image.png.157ce1ed4e0180c06a9f549196b48c8a.png 

Added:  Here is the link to playback the last a couple minutes of the flight. 
 https://www.flightradar24.com/2020-03-13/21:42/12x/N777WP/242cb4f9

Edited by JBear
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No no this guy probably wasn't on oxy up at 10 or 11 K for all that time. Came down fast and then oops hypoxia.I know I've had it.  Betting he was over 40. Got behind the plane. Stall spin crash burn. Bad day. Use oxy when you need it.

He would have recovered quickly, I can return to normal readings in seconds when I go back on O2. Unless it was a CO problem, that can take a week for even a moderate exposure.
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3 hours ago, ArtVandelay said:


He would have recovered quickly, I can return to normal readings in seconds when I go back on O2. Unless it was a CO problem, that can take a week for even a moderate exposure.

Both normalization of blood O2 saturation and the resulting improvement in mental ability is near-instantaneous when descending to lower altitudes.  I would not have expected it to be a major factor here.

CO's hemoglobin-bound circulatory half life is about 5 hours and not reflected in O2 sat.

Severe CO poisoning episodes can have lasting neurologic effects for days, weeks, even months after the CO is gone from the system.

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Tough recording to listen to. There are many questions I have about the flight and accident, about the pilot and his experience. However for now, I feel for the families.

In the air carrier world, we have a lot of support mechanisms, union support for families, company support, government agencies, and very large peer groups for emotional support. All of these assist family and survivors in coping with questions afterwards.

General aviation is different. You’re typically alone, single pilot, you have no large support network, only people on sidelines quarterbacking or civilians who don’t understand aviation. We fly older planes with, in my case, very dated avionics and no autopilot. My training regimen is self designed, there are no maintenance techs checking over plane when I’m at the hotel, no dispatcher verifying I can get through weather, no one monitoring my flight unless I ask or file IFR.

Let’s all remember we ain’t supermen, we aren’t flying missions to save lives, we can always drive or buy a ticket, or go the next day when the sun is shining. My heart goes out to the families.


Sent from my iPhone using Tapatalk

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1 hour ago, BigD said:

Tough recording to listen to. There are many questions I have about the flight and accident, about the pilot and his experience. However for now, I feel for the families.

In the air carrier world, we have a lot of support mechanisms, union support for families, company support, government agencies, and very large peer groups for emotional support. All of these assist family and survivors in coping with questions afterwards.

General aviation is different. You’re typically alone, single pilot, you have no large support network, only people on sidelines quarterbacking or civilians who don’t understand aviation. We fly older planes with, in my case, very dated avionics and no autopilot. My training regimen is self designed, there are no maintenance techs checking over plane when I’m at the hotel, no dispatcher verifying I can get through weather, no one monitoring my flight unless I ask or file IFR.

Let’s all remember we ain’t supermen, we aren’t flying missions to save lives, we can always drive or buy a ticket, or go the next day when the sun is shining. My heart goes out to the families.


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Great thoughts. Many years ago, I was planning to make a trip from Anchorage to Kodiak. The weather wasn’t great. I wanted to go. My wife convinced me it was more prudent to wait. We arrived in good VFR about 3 hours after another plane had hit the mountains during a missed approach in low IFR. How’s the saying go? There but for the grace of God...

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On 3/16/2020 at 1:21 AM, PT20J said:

Great thoughts. Many years ago, I was planning to make a trip from Anchorage to Kodiak. The weather wasn’t great. I wanted to go. My wife convinced me it was more prudent to wait. We arrived in good VFR about 3 hours after another plane had hit the mountains during a missed approach in low IFR. How’s the saying go? There but for the grace of God...

I think it’s more akin to knowing and respecting your personal mins and accepting the possibility that “I am not proficient” and “I or my equipment is not up to task today” and knowing when to scrub. SP IFR IMC can be challenging but rewarding prospect when the pilot and equipment are in line with the environmental demands.  When there is a mismatch or there are external pressures driving the bus we get results like this tragedy.  Having the humility and courage to call it off when it’s not going to work- that’s the thing that saves lives. 
 

@PT20J why’d that plane smack a mountain on a missed? Loss of situational awareness most likely.   Sounds like your decision on that particular day was an example of maintaining situational awareness and making a prudent decision given the circumstances.  Probably less about the “go there I but the grace of god” aspect. 

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Regardless of proficiency, if one is so off course on an ILS the ATC issues a warning, it's likely good SOP to smoothly execute the missed and reassess.  There may have been something wrong with the aircraft, the instruments or the pilot. He sounded almost surprised when ATC told him he was right of course. If he reacted without assessing why he was off course, he may have gone from just an instrument problem to severe disorientation in short order. 

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That transcription is incomplete. The controller continues to repeat “fly straight and level”. 
 
when someone is clearly having an issue repeating the same useless comment is not useful or helpful in any way. 


There is a good chance that an overwhelmed pilot won’t hear anything a controller says. In times of stress, our situational awareness drops as our focus narrows significantly. That’s why it’s important to focus on what will keep one alive: “Aviate, Navigate, Communicate.”

Perhaps a calm voice reminding one to “fly the airplane” can be helpful, if it is heard. Van Nuys is one of the busiest GA airports in the country, and its controllers are top-notch professionals. This transcript reflects that: As the controller recognized a pilot in distress and tried to talk him back to this basic—just leveling the wings as asked might have saved lives here.

It’s a tragedy for the lives lost and families impacted, but let’s not forget the impact on the controllers working the situation who had to watch an airplane leave their screen, knowing humans were imperiled, and trying to do whatever they could to help. Those in the tower that day will also carry some heavy memories of this incident.

Speculation and sniping doesn’t add any value and diminishes the collective professionalism of the thoughtful and dedicated pilots here. Let’s wait for the NTSB to do its job.
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Rule changes shouldn't be necessary, but a little self control and restraint and context (survivors, controllers, friends on line?) goes a long way. Sharing information can be helpful to other pilots to think about what ifs, and how to avoids. We don't need to wait for the NTSB report, which is not always conclusive in anyway. 

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  Some would argue that speculation, rumor mongering  and sniping are the only real purposes and reasons for existence of online blogs.  


I agree, some would argue anything. But man, I hope that argument is wrong. Speculation, rumor-mongering and sniping are not why I’m here. MS gathers a wealth of expertise on myriad Mooney subjects and aviation generally. That’s all fact and expert opinion, and bringing all of that together in one place is tremendously valuable.

There are also numerous friends and acquaintances I see occasionally with whom it is great to interact. Even if we only see each other once or twice a year, it’s great to connect.

I am sure it’s too much of a burden to monitor every post. If zillion-dollar Silicon Valley companies can’t do it, how can MS?

For those who snipe because they feel they can offer neither knowledge nor expertise, try a joke now and then. Share your personal experience. Like all of us, continue to build your knowledge base and expertise.

But above all, take the guessing, sniping and rumor-mongering back to Twitter, FaceBook or wherever middle-schoolers gather nowadays.
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Rule changes shouldn't be necessary, but a little self control and restraint and context (survivors, controllers, friends on line?) goes a long way. Sharing information can be helpful to other pilots to think about what ifs, and how to avoids. We don't need to wait for the NTSB report, which is not always conclusive in anyway. 


This is exactly what I’m saying. Sharing INFORMATION. Speculation or guesses aren’t information, and elevating either to the level of fact creates confusion and can create issues for others who remember casually reading it on MS but don’t readily distinguish between actual fact and someone’s guess.

We can and must police ourselves.
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7 hours ago, N9201A said:


I am sure it’s too much of a burden to monitor every post.

 

I have read every post up to about a few days ago...

I took the weekend off to get out before the viral impact reaches NJ...

 

1) MSers are good at discussing issues and potential issues related to accidents...

2) There is no shutting down safety conversations... they may be unrelated to the accident... but they are still safety conversations...

3) Some things go outside the lines... somebody will report it...

4) If it continues to be improper... posts get eliminated, threads get locked down, people get ejected from MS...

5) use caution when drinking and posting...

6) Some guidance has developed over the decade...

7) There are no specific rules... 

8) There are a few goals... everyone wants to be some form of EAG...   established aviation gentleperson... :)

9) Remember... at the next Mooney fly-in you want to go to... those same people will be there...

10) Pay it forward... lend a hand... post a pic... launch a video... rotate a pic for somebody else... copy a link... look up a part number...

11) You may also find the person with the writing style you don’t like... may have the answer you are looking for next week...

12) I once gave a goofy new MSer some advice regarding his new2him Mooney Eagle regarding his fuel tanks... a year later... I asked him how we knew each other... He was my new CFII for re-learning how to fly my O... he reminded me of the Conversation... six months after that... he was helping be get an engine OH’d... (proof that you never know...) (memories of @Cris)

13) Always Stay pleasant... :)

It isn’t very hard...

PP thoughts only...

Best regards,

-a-

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